Expandable implant assembly

ABSTRACT

An expandable implant includes a top support configured to engage a first portion of vertebral bone, a bottom support configured to engage a second portion of vertebral bone, and a control assembly coupled to the top support and the bottom support and configured to control relative movement between the top support and the bottom support. The control assembly includes a control member including a head and a body portion. The head includes a recess and the body portion includes at least one access port in fluid communication with the recess to enable delivery of fluid to an interior of the implant via the recess and at least one access port.

CROSS-REFERENCE TO RELATED PATENT APPLICATIONS

This application is a continuation of U.S. application Ser. No.16/548,134, filed Aug. 22, 2019, which is a continuation of U.S.application Ser. No. 15/497,044, filed Apr. 25, 2017, now U.S. Pat. No.10,426,632, which is a continuation-in-part of U.S. application Ser. No.14/714,821, filed May 18, 2015, now U.S. Pat. No. 9,801,733, which is acontinuation-in-part of U.S. application Ser. No. 13/802,110, filed Mar.13, 2013, now U.S. Pat. No. 9,034,041, all of which are incorporatedherein by reference in their entireties. This application is related toU.S. application Ser. No. 15/497,011, filed Apr. 25, 2017, which isincorporated herein by reference in its entirety.

BACKGROUND

The present disclosure relates to spinal interbody and intravertebralbody devices and, more particularly, to vertebral interbody andintravertebral devices that are expandable after spinal placementthereof.

Fusion cages, as well as other types of bodies and/or devices, arefrequently utilized in spinal surgery inside a vertebra (intravertebral)and/or between vertebrae of a patient (interbody). With interbodydevices, one or more such spinal bodies are placed between vertebrae toprovide support and promote fusion between adjacent vertebrae where suchis necessary due to disease, injury, general deterioration or congenitalproblem. With intravertebral devices, one or more spinal bodies areplaced within a vertebra. Spinal devices, such as fusion cages and/orthe like, are inserted into a spinal space either anteriorly,posteriorly, laterally or posteriolaterally.

A problem with most spinal interbody and intravertebral devices is thatthey are static in size. This poses various problems with their useand/or implantation. Particularly, static sized spinal devices arefairly large in order to properly bridge the gap between adjacentvertebrae. This large size does not lend itself to microsurgery,arthroscopic surgery or the like.

A few interbody devices, however, are now being made that areexpandable. Expandable interbody devices allow the interbody device tobe initially smaller than traditional non-expandable (static) interbodydevices such that expandable interbody devices may be more easilyinserted or implanted into the vertebral space. Moreover, expandableinterbody devices allow the surgeon to set the amount of expansionnecessary for the particular patient rather than the static interbodydevice dictating the spacing.

SUMMARY

One embodiment relates to an expandable implant, comprising a topsupport assembly defining an upper surface configured to engage a firstportion of vertebral bone; a bottom support assembly defining a lowersurface configured to engage a second portion of vertebral bone; acontrol assembly coupled to the top support assembly and the bottomsupport assembly and configured to control relative movement between thetop support assembly and the bottom support assembly between a collapsedposition and an expanded position; wherein in the collapsed position,the upper surface is generally parallel to the lower surface, andwherein in the expanded position, a portion of the upper surface extendsat an acute angle relative to a portion of the lower surface.

Another embodiment relates to an expandable implant comprising a topsupport assembly defining an upper surface configured to engage a firstportion of vertebral bone; a bottom support assembly defining a lowersurface configured to engage a second portion of vertebral bone; a firstwedge member slidably coupled to the top and bottom support assemblies;a second wedge member slidably coupled to the top and bottom supportassemblies; and a control assembly coupled to the first and second wedgemembers and configured to control relative movement between the topsupport assembly and the bottom support assembly between a collapsedposition and an expanded position; wherein in the collapsed position,the upper surface is generally parallel to the lower surface, andwherein in the expanded position, a portion of the upper surface extendsat an angle relative to a portion of the lower surface.

Another embodiment relates to a method of using an expandable implant,comprising providing an expandable implant comprising a top supportassembly, a bottom support assembly, and a control assembly coupled tothe top and bottom support assemblies; manipulating the control assemblyin a first manner to move the top support assembly in a linear fashionrelative to the bottom support assembly; and manipulating the controlassembly in a second manner to move at least a portion of the topsupport assembly in a non-linear fashion relative to at least a portionof the bottom support assembly.

Another embodiment relates to an expandable implant, comprising a topsupport configured to engage a first portion of vertebral bone; a bottomsupport configured to engage a second portion of vertebral bone; and acontrol assembly coupled to the top support and the bottom support andconfigured to control relative movement between the top support and thebottom support, wherein the control assembly includes a control memberincluding a head and a body portion; and wherein the head includes arecess and the body portion includes at least one access port in fluidcommunication with the recess to enable delivery of fluid to an interiorof the implant via the recess and at least one access port.

Another embodiment relates to an expandable implant, comprising a topsupport including a top surface configured to engage a first portion ofvertebral bone; a bottom support including a bottom surface configuredto engage a second portion of vertebral bone, wherein the top and bottomsurfaces define a taper; and a control assembly coupled to the topsupport and the bottom support and configured to control relativemovement between the top support and the bottom support, wherein thecontrol assembly includes a control member having a recess and at leastone access port in fluid communication with the recess to enabledelivery of fluid to an interior of the implant via the recess and atleast one access port.

Another embodiment relates to an implant comprising a top supportconfigured to engage a first portion of vertebral bone; a bottom supportconfigured to engage a second portion of vertebral bone; and a controlassembly coupled to the top support and the bottom support andconfigured to control relative movement between the top support and thebottom support, wherein the control assembly includes a front portionconfigured to slidably engage the top and bottom supports; a rearportion configured to slidably engage the top and bottom supports; and acontrol member including a head disposed within the rear portion, and athreaded portion threadingly engaging the front portion; wherein thehead includes a recess and at least one access port in fluidcommunication with the recess to enable delivery of fluid to an interiorof the implant via the recess and at least one access port.

BRIEF DESCRIPTION

The foregoing and other features of the present invention will becomemore apparent to one skilled in the art upon also reading the followingdescription of embodiments with reference to the accompanying drawings.

FIG. 1 is a side view of a portion of a human spine illustratinginter-vertebral placement of an expandable interbody/intravertebral bodydevice in accordance with the principles of the present invention.

FIGS. 2-15 show various views of an expandable implant according to oneembodiment.

FIGS. 16-30 show various views of an expandable implant according to analternative embodiment.

FIGS. 31-38 show various views of an expandable implant according to analternative embodiment.

FIGS. 39-46 show various views of an expandable implant according to analternative embodiment.

FIGS. 47-49 show various views of an expandable implant according to analternative embodiment.

FIGS. 50-53 show various views of an expandable implant according to analternative embodiment.

FIGS. 54-65 show various views of an expandable implant according to analternative embodiment.

FIGS. 66-70 show various views of an expandable implant according to analternative embodiment.

FIGS. 71-75 show various views of an expandable implant according to analternative embodiment.

FIGS. 76-83 show various views of an expandable implant according to analternative embodiment.

FIG. 84 shows a portion of an expandable implant according to analternative embodiment.

Corresponding reference characters indicate corresponding partsthroughout the several views. Although the drawings representembodiments of the invention, the drawings are not necessarily to scaleand certain features may be exaggerated in order to better illustrateand explain the principles of the present invention. Theexemplifications set out herein illustrate several embodiments of theinvention, but the exemplifications are not to be construed as limitingthe scope of the invention in any manner.

DETAILED DESCRIPTION

The present disclosure relates to expandable and/or dynamic interbody(between adjacent vertebrae), intravertebral-body (inside the vertebrae)and/or spinal stabilization devices that may or may not be used asinterbody fusion cages or devices, interbody/intravertebral bodies/bodystabilization devices and/or the like (collectively hereinafter, spinaldevice(s)) for providing support, stabilization and/or promoting bonegrowth between or inside vertebrae that have been destabilized orotherwise due to injury, illness and/or the like. Particularly, thepresent disclosure provides various versions of dynamic (expandableand/or expandable and retractable) interbody/intravertebral body devicesthat are usable in a spinal column of a human.

As representative of each one of the various versions of the presentinvention, FIG. 1 illustrates a representative dynamic spinal bodydevice or expandable implant 10. The implant 10 is depicted as implantedor inserted into a human spine 13 of which only a lower portion of thespine 13 is shown. The implant 10 is illustrated implanted betweenadjacent upper and lower vertebrae 15, 17 of the spine 13 in FIG. 1(hence interbody or intervertebral). Vertebrae 15 and 17 have portionsthat face anteriorly (“A”, and from the right as viewed in FIG. 1) andportions that face posteriorly (“P”, and from the left as viewed in FIG.1).

According to various exemplary embodiments, the components of implant 10may be made of any suitable material(s), including a variety of metals,plastics, composites, or other suitable bio-compatible materials. Insome embodiments, one or more components of implant 10 may be made ofthe same material, while in other embodiments, different materials maybe used for different components of implant 10.

Referring now to FIGS. 2-15, expandable implant 10 is shown according toan exemplary embodiment. Implant 10 is usable, for example, betweenand/or within vertebral bodies of the spine, and may share many of thefeatures of the other inter/intra-body implants discussed elsewhereherein. It should be understood that implant 10 may in some embodimentsbe usable in other portions of the body in addition to the spine, andall such applications are to be understood to be within the scope of thepresent disclosure.

According to an exemplary embodiment, implant 10 includes a first, orfront portion 12 (e.g., a first wedge member), a second, or rear portion14 (e.g., a second wedge member), and a third, intermediate, or controlmember or portion 16, which collectively form a body or control assemblythat extends along a longitudinal axis 11 of implant 10. A first, orupper support 18 (e.g., an upper plate, support member, assembly, etc.)and a second, lower support 20 (e.g., a lower plate, support member,assembly), are coupled to the body assembly and extend generally betweenfront and rear portions 12, 14. According to an exemplary embodiment,first and second supports 18, 20 define a height of implant 10 extendingbetween outer or top surface 48 of first support 18 and outer or lowersurface 76 of second support 20.

In one embodiment, front portion 12 includes a rounded, or bull noseportion intended to facilitate insertion of implant 10 into a patient.Front portion 12 also includes ramped surfaces 26, 28 and projections30, 32 that facilitate controlled sliding movement between front portion12 and first and second supports 18, 20. An aperture 34 may be threadedto receive control member 16 to provide an adjustable control mechanismfor implant 10.

Referring to FIG. 14, ramped surface 26 extends at an angle relative toaxis 11, and projection 30 extends upward relative to ramped surface 26.Ramped surface 26 is a generally flat surface configured to engage acorrespondingly ramped surface (surface 54) on first support 18.Projection 30 extends laterally across front portion 12. In someembodiments, projection 30 may have a dovetail shape, while in otherembodiments, projection 30 may take other shapes, including having anundercut portion, etc. The dovetail shape provides a relatively largertop portion and an undercut lower portion such that front portion 12 andfirst support 18 can slide relative to one another, but the parts cannotbe separated, for example, by merely lifting first support 18 away fromfront portion 12 (e.g., in an upward direction generally perpendicularto axis 11).

Ramped surface 28 and projection 32 share similar features to rampedsurface 26 and projection 30, except that ramped surface 28 andprojection 32 interface with corresponding surfaces on second support20, rather than first support 18. It should be noted that rampedsurfaces 26, 28 may be inclined relative to axis 11 to provide anydesirable adjustment features, as changing the incline of the rampedsurfaces will change the rate at which the first and second supportmembers move up/down.

Referring further to FIG. 14, according to an exemplary embodiment, rearportion 14 includes ramped surfaces 36, 38, projections 40, 42, anaperture, or through-hole 44, and a counterbore 46. Rear portion 14 maydefine a generally flat rearward-most surface being generallyrectangular in shape. In other embodiments, the shape of rear portion 14may be varied to suit a particular application.

Ramped surface 36 extends at an angle relative to axis 11, andprojection 40 extends upward relative to ramped surface 36. Rampedsurface 36 is a generally flat surface configured to engage acorrespondingly ramped surface (surface 56) on first support 18.Projection 40 extends laterally across rear portion 14. In someembodiments, projection 40 may have a dovetail shape (see, e.g., FIG.15), while in other embodiments, projection 40 may take other shapes,including having an undercut portion etc. The dovetail shape provides arelatively larger top portion and an undercut lower portion such thatrear portion 14 and first support 18 can slide relative to one another,but the parts cannot be separated, for example, by merely lifting firstsupport 18 away from rear portion 14 (e.g., in an upward directiongenerally perpendicular to axis 11).

Ramped surface 38 and projection 42 share similar features to rampedsurface 36 and projection 40, except that ramped surface 38 andprojection 42 interface with corresponding surfaces on second support20, rather than first support 18. It should be noted that rampedsurfaces 36, 38 may be inclined relative to axis 11 to provide anydesirable adjustment features, as changing the incline of the rampedsurfaces will change the rate at which the first and second supportmembers move up/down.

According to an exemplary embodiment, first and second supports 18, 20are configured to be moveable relative to the body or control assembly(e.g., front and rear portions 12, 14 and control portion 16) such thatimplant 10 is reconfigurable between a first configuration (e.g., aretracted, collapsed, or minimal configuration), as shown in FIGS. 2-7,and a second configuration (e.g., an expanded or maximum configuration),as shown in FIGS. 8-13 and any intermediate position therebetween.Control member 16 is rotatable and threadingly received by front portion12 such that rotation of control member 16 in a first (e.g., clockwise)direction causes front and rear portions 12, 14 to move toward eachother, thereby causing first and second supports 18, 20 to move outwardtoward the expanded configuration. Conversely, rotation of controlmember 16 in a second (e.g., counter-clockwise) direction causes frontand rear portions 12, 14 to move away from each other, thereby causingfirst and second supports 18, 20 to move inward toward the collapsedconfiguration. It should be noted that in use, control member 16 may beadjusted so as to maintain first and second supports 18, 20 in a fullycollapsed configuration, a fully expanded configuration, or any desiredconfiguration or intermediate position therebetween.

First and second supports 18, 20 and front and rear portions 12, 14 havecorresponding geometric features (e.g., correspondingly ramped surfaces)such that displacement of front portion 12 relative to rear portion 14along axis 11 causes relative planar and/or linear displacement of firstand second supports 18, 20. As discussed above, the geometric featuresof the various components may be varied to provide for varyingadjustment features for first and second supports 18, 20.

In one embodiment, first and second supports 18, 20 are generallysimilar in structure. Referring to FIG. 14, first support 18 includesouter, or top surface 48, ramped surfaces 54, 56, channels 58, 59, andtwo pairs of opposing projections—projections 60, 62, and projections64, 66. First support 18 further includes sidewalls 68, 70, pin orretaining member apertures 72, and inner, or bottom surface 74. Topsurface 48 includes a number of ridges, or projections 50, intended toprovide a gripping surface for adjacent vertebrae, and a bone graftcavity, or window 52 intended to provide a space to receive bone graftmaterial.

In use, control member 16 extends through through-hole 44 in rearportion 14 and into front portion 12. Head portion 106 of control member16 seats in counterbore 46 of rear portion 14, and threaded portion 104threadingly engages aperture 34 of front portion 12. Head portion 106may include an annular recess 108 configured such that a collar 24 canbe positioned (e.g., press-fit, welded, etc.) into counterbore 46rearward of head portion 106 to retain control member 16 in place. As auser rotates control member 16, front portion 12 and rear portion 14move toward/away from each other (depending on the direction ofrotation), and first and second supports 18, 20 in turn move awayfrom/toward each other.

As shown in FIG. 14, opposing projections 60, 62 on first support 18form a recess, or channel 58. In one embodiment, channel 58 has adovetail shape corresponding in shape to projection 30 on front portion12. Likewise, projections 64, 66 in first support 18 form channel 59having a dovetail shape similar in shape to projection 40 on rearportion 14. Projections 30, 40 slide within channels 58, 59 as firstsupport 18 moves up/down. Retaining members or pins 22 extend throughfirst and second supports 18, 20 and act to limit the range of movementof first and second supports 18, 20 relative to front and rear portions12, 14, and prevent first and second supports 18, 20 from beingcompletely removed from front and rear portions 12, 14.

Second support 20 is similar to first support 18 and includes outer, orbottom surface 76, ramped surfaces 82, 84, channels 86, 87, and twopairs of opposing projections—projections 88, 90, and projections 92,94. Second support 20 further includes sidewalls 96, 98, pin orretaining member apertures 80, and inner, or top surface 102. Bottomsurface 76 includes a number of ridges, or projections 78, intended toprovide a gripping surface for adjacent vertebrae, and a bone graftcavity, or window 80 intended to provide a space to receive bone graftmaterial. In one embodiment, the components of second support 20 aresimilar in structure and function to the corresponding components offirst support 18. In other embodiments, the components of second support20 may provide additional and/or different structural and/or functionalfeatures relative to the corresponding components of first support 18.

It should be noted that implant 10 may share various features with theother implants described herein, and be made of the same, similar, ordifferent materials. For example, various components of implant 10 maybe made of metal, plastic, composites, or other suitable bio-compatiblematerials. Further, implant 10 may be usable in connection with thespine or other parts of the body.

Referring now to FIGS. 16-30, an expandable implant 110 is shownaccording to an exemplary embodiment. Implant 110 is usable, forexample, between and/or within vertebral bodies of the spine, and mayshare many of the features of the other inter/intra-body implantsdiscussed elsewhere herein. It should be understood that implant 110 mayin some embodiments be usable in other portions of the body in additionto the spine, and all such applications are to be understood to bewithin the scope of the present disclosure. Implant 110 is generallysimilar to implant 10 in structure and function except with respect tothe additional alignment features discussed below.

According to an exemplary embodiment, implant 110 includes a first, orfront portion 112, a second, or rear portion 114, and a third,intermediate, or control member or portion 116, which collectively forma body or control assembly that extends along a longitudinal axis 111 ofimplant 110. A first, or upper support 118 (e.g., an upper plate orsupport member, etc.) and a second, lower support 120 (e.g., a lowerplate or support member), are coupled to the body or control assemblyand may extend generally between front and rear portions 112, 114.According to an exemplary embodiment, first and second supports 118, 120define a height of implant 110 extending between outer or top surface148 of first support 118 and outer or lower surface 176 of secondsupport 120.

In one embodiment, front portion 112 includes a rounded, or bull noseportion intended to facilitate insertion of implant 110 into a patient.Front portion 112 also includes ramped surfaces and projections (e.g.,similar to ramped surfaces 26, 28 and projections 30, 32) thatfacilitate controlled sliding movement between front portion 112 andfirst and second supports 118, 120. An aperture may be threaded toreceive control member 116 to provide an adjustable control mechanismfor implant 110.

As shown in FIGS. 20-22, the ramped surfaces extend at an angle relativeto axis 111, and the projections extend upward/downward relative to theramped surfaces. The ramped surfaces are generally flat surfacesconfigured to engage a correspondingly ramped surface on first support118. The projections extend laterally across front portion 112. In someembodiments, the projections may have a dovetail shape, while in otherembodiments, the projections may take other shapes, including having anundercut portion, etc. The dovetail shape provides a relatively largertop portion and an undercut lower portion such that front portion 112and first support 118 can slide relative to one another, but the partscannot be separated, for example, by merely lifting first support 118away from front portion 112 (e.g., in an upward direction generallyperpendicular to axis 111). It should be noted that similar to implant10, implant 110 includes front and rear, upper and lower ramped surfacesand projections configured to provide the interface between front andrear portions 112, 114 and first and second supports 118, 120.

As with implant 10, according to an exemplary embodiment, first andsecond supports 118, 120 and front and rear portions 112, 114 havecorresponding geometric features (e.g., correspondingly ramped surfaces)such that displacement of front portion 112 relative to rear portion 114along axis 111 causes relative planar and/or linear displacement offirst and second supports 118, 120. As discussed above, the geometricfeatures of the various components may be varied to provide for varyingadjustment features for first and second supports 118, 120.

In use, control member 116 includes a head portion and a body portionand extends through a through-hole in rear portion 114 and into frontportion 112. The head portion of control member 116 seats in acounterbore of rear portion 114, and the threaded portion of the bodythreadingly engages an aperture of front portion 112. The head portionmay include an annular recess (similar to head portion 106 of implant10) configured such that a collar 124 can be positioned (e.g.,press-fit, welded, etc.) into the counterbore rearward of the headportion to retain control member 116 in place. As a user rotates controlmember 116, front portion 112 and rear portion 114 move toward/away fromeach other (depending on the direction of rotation), and first andsecond supports 118, 120 in turn move away from/toward each other. Whilethe Figures generally show control member 116 threadingly engaging frontportion 112, in other embodiments, other adjustment mechanisms may beused (e.g., ratchet mechanisms, indents/detents, etc.).

Opposing projections 160, 162 on first support 118 form a recess, orchannel 158. In one embodiment, channel 158 has a dovetail shapecorresponding in shape to projection 130 on front portion 112. Likewise,projections 164, 166 in first support 118 form channel 159 having adovetail shape similar in shape to projection 140 on rear portion 114.Projections 130, 140 slide within channels 158, 159 as first support 118moves up/down. In some embodiments, retaining members or pins (e.g.,similar to pins 22) extend through first and second supports 118, 120and act to limit the range of movement of first and second supports 118,120 relative to front and rear portions 112, 114, and prevent first andsecond supports 118, 120 from being completely removed from front andrear portions 112, 114. Second support 120 includes similar featuressuch as an outer, or bottom surface, ramped surfaces, channels, and twopairs of opposing projections.

In addition to including various features of implant 10, implant 110further includes an alignment feature intended to maintain alignmentbetween first and second supports 118, 120 during use. In oneembodiment, second support 120 includes one or more alignment members150, 152 (e.g., extensions, projections, etc.) that extend generallyupward as shown in FIG. 19 (e.g., in a direction generally perpendicularto axis 111). Members 150, 152 are received in recesses 154, 156 (e.g.,channels, grooves, slots, etc.), respectively, formed in first support118. Members 150, 152 and recesses 154, 156 have corresponding geometricfeatures to ensure a snug fit between components. For example, as shownin FIG. 16, members 150, 152 are generally U-shaped in cross-section,and recesses 154, 156 are shaped to receive the U-shaped members. Thealignment features prevent relative “rocking” of the supports, and insome embodiments serve to maintain a generally parallel relationshipbetween the supports. In some embodiments, spaces or gaps may beprovided between members 150, 152 and recesses 154, 156 to enable apredetermined amount of angular offset between the supports.

In one embodiment members 150, 152 are formed so as to be generallyflush with the exterior surface of first support 118 (e.g., along a sideor top surface). In other embodiments, members 150 may be recessed from,or alternatively protrude beyond, the exterior surface of first support118. Further, while FIGS. 16-30 show two alignment members 150, 152, invarious alternative embodiments fewer or more alignment members and/orrecesses may be utilized (e.g., 1, 3, 4, etc.). Further yet, members150, 152 may be integrally formed with, or removably coupled to, aremainder portion of second support 120. In further embodiments, therelative positions of alignment members 150, 152 and recesses 154, 156are reversed (e.g., such that members 150, 152 are provided on firstsupport 118 and recesses 154, 156 are provided on second support 120).Other variations in the size, number, and placement of members 150, 152and recesses 154, 156 may be made according to various embodiments.

It should be noted that implant 110 may share various features with theother implants described herein, and be made of the same, similar, ordifferent materials. For example, various components of implant 110 maybe made of metal, plastic, composites, or other suitable bio-compatiblematerials. Further, implant 110 may be usable in connection with thespine or other parts of the body. Further yet, pins similar to pins 22may be used in conjunction with implant 110 or any of the other implantsshown and described herein.

In various embodiments, the implants shown in FIGS. 1-15 and 16-30 sharevarious common features. For example, the control member or screw (e.g.,16, 116) is contained within the device, such that neither end of thecontrol member or screw protrudes past the end members. For example, asshown in FIG. 14, the control member 16 may be received by or throughrear portion 14 in a counterbore and held captive by collar or ring 24,such that control member 16 is free to rotate within rear portion 14,but does not threadingly engage rear portion 14. As such, rear portion14 remains fixed relative to control member 16 as control member 16 isrotated. Control member 16 threadingly engages a threaded aperture 34defined by a boss extending rearward from front portion 12, such that ascontrol member 16 rotates, front portion 12 moves relative to controlmember 16 (e.g., control member 16 moves into or out of the threadedboss of front portion 12). As such, control member 16 is containedentirely within the periphery of front and rear portions 12, 14. Thecontrol member 16 may in some embodiments be configured to be flush withthe outer sides of front and rear portions 12, 14. In other embodiments,the control member 16 is recessed within front and/or rear portions 12,14. For example, as shown in FIG. 14, front portion 12 has a solid,bull-nose configuration such that control member 16 is concealedtherein. In various embodiments, the implants include grooves that mayhelp secure the implant in the body of a patient, by providing spacesfor structures in the body of a patient to engage the grooves.

Referring now to FIGS. 31-38, an implant 210 is shown according to anexemplary embodiment. Implant 210 is usable, for example, between and/orwithin vertebral bodies of the spine, and may share many of the featuresof the other inter/intra-body implants discussed elsewhere herein. Itshould be understood that implant 210 may in some embodiments be usablein other portions of the body in addition to the spine, and all suchapplications are to be understood to be within the scope of the presentdisclosure. Implant 210 is generally similar to implants 10 and 110 instructure and function except with respect to the additional access portfeatures discussed below. As such, implant 210 is understood to includeany or all of the features of implants 10 and 110 to the extentconsistent with the additional features of implant 210 described herein(e.g., retention pins, dovetail projections and ramped surfaces,alignment features, etc.).

According to an exemplary embodiment, implant 210 includes a first, orfront portion 212, a second, or rear portion 214, and a third,intermediate, or control member or portion 216, which collectively forma body or control assembly that extends along a longitudinal axis ofimplant 210. A first, or upper support 218 (e.g., an upper plate orsupport member, etc.) and a second, lower support 220 (e.g., a lowerplate or support member), are coupled to the body assembly and mayextend generally between front and rear portions 212, 214. According toan exemplary embodiment, first and second supports 218, 220 define aheight of implant 210 extending between the outer or top surface offirst support 218 and the outer or lower surface of second support 220.

In one embodiment, control member 216 includes a head portion 230, acollar recess 232, a threaded portion 234, a tool recess 236, and accessports 238. Threaded portion 234 and the non-threaded portion of controlmember 216 including access ports 238 collectively form a body portionfor control member 216. Head portion 230 is received within acounterbore in rear portion 214. Collar recess 232 is configured toenable placement of collar 224 into a position to retain head portion230 within the counterbore in rear portion 214. Threaded portion 234 isconfigured to threadingly engage a threaded aperture provided by frontportion 212. Tool recess 236 is formed in the rearward portion of headportion 230 and communicates with access ports 238, which extend toopposite sides of control member 216. Tool recess 236 is configured toreceive a tool to enable threading manipulation of control member 216.Tool recess 236 and access ports 238 are collectively configured toprovide a fluid path to an interior of implant 210 and enable deliveryof fluid, bone growth material, or other material to an interior ofimplant 210.

As shown in FIGS. 35-38, in one embodiment, two access ports 238 are incommunication with tool recess 236 and extend to opposite sides ofcontrol member 216. In other embodiments, more or fewer access ports 238may be utilized, and the size and shape of the individual access ports238 may be varied to suit a particular application, size of implant, andthe like. Access ports 238 are positioned to provide fluid communicationwith an interior area of implant 210.

Referring to FIGS. 39-46, an implant 260 is shown according to anexemplary embodiment. Implant 260 is usable, for example, between and/orwithin vertebral bodies of the spine, and may share many of the featuresof the other inter/intra-body implants discussed elsewhere herein. Itshould be understood that implant 260 may in some embodiments be usablein other portions of the body in addition to the spine, and all suchapplications are to be understood to be within the scope of the presentdisclosure. Implant 260 is generally similar to implants 10, 110, and210 (and the other implants described herein) in structure and functionexcept with respect to the additional conical projection, side bonegraft window, and elongated component features discussed below. As such,implant 260 is understood to include any or all of the features of theother implants described herein to the extent consistent with theadditional features of implant 260 described herein (e.g., retentionpins, dovetail projections and ramped surfaces, alignment features,control member access port(s), etc.).

According to an exemplary embodiment, implant 260 includes a first, orfront portion 262, a second, or rear portion 264, and a third,intermediate, or control member or portion 266, which collectively forma body or control assembly that extends along a longitudinal axis ofimplant 260. A first, or upper support 268 (e.g., an upper plate orsupport member, etc.) and a second, lower support 270 (e.g., a lowerplate or support member), are coupled to the body assembly and mayextend generally between front and rear portions 262, 264. According toan exemplary embodiment, first and second supports 268, 270 define aheight of implant 260 extending between the outer or top surface offirst support 268 and the outer or lower surface of second support 270.

In one embodiment, control member 266 includes a head portion 280, acollar recess 282, a threaded portion 284, a tool recess 286, and accessports 288. Head portion 280 is received within a counterbore in rearportion 264. Collar recess 282 is configured to enable placement ofcollar 274 into a position to retain head portion 280 within thecounterbore of rear portion 264. Threaded portion 284 is configured tothreadingly engage a threaded aperture provided by front portion 262.Tool recess 286 is formed in the rearward portion of head portion 280and communicates with access ports 288, which extend to opposite sidesof control member 266. Tool recess 286 is configured to receive a toolto enable threading manipulation of control member 266. Tool recess 286and access ports 288 are collectively configured to provide a fluid pathto an interior of implant 260 and enable delivery of fluid, bone growthmaterial, or other material to an interior of implant 260.

Referring to FIGS. 45-46, in one embodiment implant 260 defines a firstside 290 and a second, opposite side 292. First and second sides 290,292 are generally formed by the sidewalls of top and bottom supports268, 270. In one embodiment, one or both of first and second sides 290,292 include side bone graft apertures or windows. For example, as shownin FIG. 45, in some embodiments, first side 290 includes side apertures294 and second side 292 forms a generally solid sidewall. While FIG. 45illustrates first side 290 as including two bone graft apertures 294,according to various alternative embodiments, one or both of first side290 and second side 292 may include more or fewer side apertures. Insome embodiments, one or both of top and bottom supports 268, 270 mayinclude a projection 296 (e.g., a conical projection) at one or bothends. Projections 296 may extend above the other portions of top andbottom supports 268, 270 (e.g., teeth, etc.)

In some embodiments, top and bottom supports 268, 270 have a generallysymmetric profile about control member 266, as shown for example, inFIG. 42. Implant 260 may further be elongated relative to other implantsillustrated herein, having an overall length to overall width ratio (inthe collapsed configuration) of 2, 3, 4, or more (or another ratio, suchas a range of between 2 and 5, between 2 and 4, etc.).

Referring to FIGS. 47-49, an implant 310 is shown according to anexemplary embodiment. Implant 310 is usable, for example, between and/orwithin vertebral bodies of the spine, and may share many of the featuresof the other inter/intra-body implants discussed elsewhere herein. Itshould be understood that implant 310 may in some embodiments be usablein other portions of the body in addition to the spine, and all suchapplications are to be understood to be within the scope of the presentdisclosure. Implant 310 is generally similar to implants 260 (and theother implants described herein) in structure and function except withrespect to the additional asymmetric component features discussed below.As such, implant 310 is understood to include any or all of the featuresof the other implants described herein to the extent consistent with theadditional features of implant 310 described herein (e.g., retentionpins, dovetail projections and ramped surfaces, alignment features,control member access port(s), etc.).

According to an exemplary embodiment, implant 310 includes a first, orfront portion 312, a second, or rear portion 314, and a third,intermediate, or control member or portion 316, which collectively forma body or control assembly that extends along a longitudinal axis ofimplant 310. A first, or upper support 318 (e.g., an upper plate orsupport member, etc.) and a second, lower support 320 (e.g., a lowerplate or support member), are coupled to the body assembly and mayextend generally between front and rear portions 312, 314. According toan exemplary embodiment, first and second supports 318, 320 define aheight of implant 310 extending between the outer or top surface offirst support 318 and the outer or lower surface of second support 320.

In one embodiment, implant 310 defines a first side portion 330 and asecond side portion 332. In one embodiment, one or both of first andsecond side portions 330, 332 include side bone graft apertures orwindows. For example, as shown in FIG. 48, in some embodiments, firstside 330 includes side apertures 334. While FIG. 48 illustrates firstside 330 as including two bone graft apertures 334, according to variousalternative embodiments, one or both of first side 330 and second side332 may include more or fewer side apertures.

In some embodiments, first side portion 330 and second side portionprovide an asymmetric profile about control member 316, as shown forexample in FIG. 49. In some embodiments, a portion of first side portion330 extends away from control member 316 a further distance than thecorresponding portions of second side portion 332, forming an asymmetricshape (e.g., a “D” or similar shape). Providing an asymmetric profilemay provide benefits in particular applications where additional supportis desired and/or when placement of implant 310 is difficult. WhileFIGS. 47-49 shown implant 310 having a general “D” asymmetric shape,according to various alternative embodiments, other asymmetric shapesand configurations may be utilized.

Referring to FIGS. 50-53, an implant 360 is shown according to anexemplary embodiment. Implant 360 is usable, for example, between and/orwithin vertebral bodies of the spine, and may share many of the featuresof the other inter/intra-body implants discussed elsewhere herein. Itshould be understood that implant 360 may in some embodiments be usablein other portions of the body in addition to the spine, and all suchapplications are to be understood to be within the scope of the presentdisclosure. Implant 360 is generally similar to implants 260 and 310(and the other implants described herein) in structure and functionexcept with respect to the additional lateral taper features discussedbelow. As such, implant 360 is understood to include any or all of thefeatures of the other implants described herein to the extent consistentwith the additional features of implant 360 described herein (e.g.,retention pins, dovetail projections and ramped surfaces, alignmentfeatures, control member access port(s), etc.).

According to an exemplary embodiment, implant 360 includes a first, orfront portion 362, a second, or rear portion 364, and a third,intermediate, or control member or portion 366, which collectively forma body or control assembly that extends along a longitudinal axis ofimplant 360. A first, or upper support 368 (e.g., an upper plate orsupport member, etc.) and a second, lower support 370 (e.g., a lowerplate or support member), are coupled to the body or control assemblyand may extend generally between front and rear portions 362, 364.According to an exemplary embodiment, first and second supports 368, 370define a height of implant 360 extending between the outer or topsurface of first support 368 and the outer or lower surface of secondsupport 370. As discuss in greater detail below, the height of implant360 decreases in a lateral direction.

In one embodiment, implant 360 defines a first side portion 380 and asecond side portion 382. In one embodiment, one or both of first andsecond side portions 380, 382 include side bone graft apertures orwindows. For example, as shown in FIG. 50, in some embodiments, secondside 382 includes side apertures 384. While FIG. 50 illustrates secondside 382 as including two bone graft apertures 384, according to variousalternative embodiments, one or both of first side 380 and second side382 may include more or fewer side apertures.

In one embodiment, implant 360 is configured to provide a predeterminedlateral taper that remains constant as implant 360 is moved between acollapsed configuration (see FIGS. 50-51) and an expanded configuration(see FIGS. 52-53). For example, referring to FIG. 51, in a collapsedconfiguration, a first lateral side such as side 380 may have a firstheight that is larger than a height of second lateral side 382. Thedegree of taper between the first and second lateral sides 380, 382 maybe adjusted to suit a particular embodiment (e.g., a desired spinalcurvature). As such, both the top and bottom supports 368, 370 mayinclude outer surfaces (e.g. top and bottom surfaces) that define alateral angular offset from a parallel configuration (e.g., aconfiguration where the top and bottom supports 368, 370 are generallyparallel).

As shown in FIGS. 51 and 53, top and bottom supports 368 and 370 movetoward and away from each other in a linear manner, such that the degreeof taper remains constant. In other embodiment, other configurations maybe utilized to provide non-linear movement and a varying lateral taper.Furthermore, while FIGS. 50-53 illustrate an implant having a constantlateral taper, according to various alternative embodiments, implantsmay be provided having a variable longitudinal taper.

Referring to FIGS. 54-65, an implant 410 is shown according to anexemplary embodiment. Implant 410 is usable, for example, between and/orwithin vertebral bodies of the spine, and may share many of the featuresof the other inter/intra-body implants discussed elsewhere herein. Itshould be understood that implant 410 may in some embodiments be usablein other portions of the body in addition to the spine, and all suchapplications are to be understood to be within the scope of the presentdisclosure. Implant 410 is generally similar to implants 260 and 310(and the other implants described herein) in structure and functionexcept with respect to the additional longitudinal taper featuresdiscussed below. As such, implant 410 is understood to include any orall of the features of the other implants described herein to the extentconsistent with the additional features of implant 410 described herein(e.g., retention pins, dovetail projections and ramped surfaces,alignment features, control member access port(s), etc.).

According to an exemplary embodiment, implant 410 includes a first, orfront portion 412, a second, or rear portion 414, and a third,intermediate, or control member or portion 416, which collectively forma body or control assembly that extends along a longitudinal axis ofimplant 410. In some embodiments, front portion 412 includes a throughhole 431 configured to enable control member 416 to extend through frontportion 412. A first, or upper support 418 (e.g., an upper plate orsupport member, etc.) and a second, lower support 420 (e.g., a lowerplate or support member), are coupled to the body or control assemblyand may extend generally between front and rear portions 412, 414.According to an exemplary embodiment, first and second supports 418, 420define a height of implant 410 extending between the outer or topsurface of first support 418 and the outer or lower surface of secondsupport 420. As discuss in greater detail below, the height of implant410 decreases in a longitudinal direction (e.g., to provide alongitudinal taper feature).

In one embodiment, implant 410 is configured to provide a predeterminedlongitudinal taper that remains constant as implant 410 is moved betweena collapsed configuration (see FIGS. 54-55) and an expandedconfiguration (see FIGS. 57-58). As such, both the top and bottomsupports 418, 420 may include outer surfaces (e.g. top and bottomsurfaces) that define a lateral angular offset from a parallelconfiguration (e.g., a configuration where the top and bottom supports418, 420 are generally parallel).

In some embodiments, implant 410 defines a longitudinal axis extendingalong control member 416. Top support 418 defines a first end 426, asecond end 428, and a top surface 421 extending between first and secondends 426, 428. First and second ends 426, 428 define an overall taper totop surface 421. In some embodiments, top surface 421 may define anarcuate shape between first end 426 and second end 428 (e.g., such thattop surface 421 has a slight curvature between first and second ends426, 428). In other embodiments, top surface 421 may define asubstantially planar surface between first and second ends 426, 428.Bottom support 420 defines a first end 425, a second end 427, and abottom surface 423 extending between first and second ends 425, 427.First and second ends 425, 427 define an overall taper to top surface423. In some embodiments, top surface 423 may define an arcuate shapebetween first end 425 and second end 427 (e.g., such that top surface423 has a slight curvature between first and second ends 425, 427). Inother embodiments, top surface 423 may define a substantially planarsurface between first and second ends 425, 427.

As shown in FIGS. 54-58, top and bottom supports 418 and 420 move towardand away from each other in a linear manner, such that the degree oftaper remains constant. In other embodiment, other configurations may beutilized to provide non-linear movement and a varying longitudinaltaper. Furthermore, while FIGS. 54-58 illustrate an implant having aconstant longitudinal taper, according to various alternativeembodiments, implants may be provided having a variable longitudinaltaper.

Referring to FIGS. 61-65, in some embodiments, implant 410 includes oneor more retaining members to retain control member 416 in a desiredlongitudinal position. For example, as shown in FIG. 61, in oneembodiment, implant 410 includes retaining members 422 received in sideapertures 424 on opposing sides of rear support 414. Control member 416includes a head portion 430, a groove 432, and a threaded portion 434.Control member 416 further includes a tool recess 436 in fluidcommunication with access ports 438. Retaining members 422 areconfigured to extend through rear support 414 and be received withingroove 432 of control member 416, such that control member 416 islongitudinally fixed relative to rear support 414, but also rotatablerelative to rear support 414. FIG. 61 illustrates retaining members 422extending into rear support 414 from opposing lateral sides. In variousalternative embodiments, retaining members may be used that extendthrough other portions, such as opposing top and bottom sides.

For example, referring to FIGS. 66-70, an implant 460 is shown accordingto an exemplary embodiment. Implant 460 is usable, for example, betweenand/or within vertebral bodies of the spine, and may share many of thefeatures of the other inter/intra-body implants discussed elsewhereherein. It should be understood that implant 460 may in some embodimentsbe usable in other portions of the body in addition to the spine, andall such applications are to be understood to be within the scope of thepresent disclosure. Implant 460 is generally similar to the otherimplants described herein in structure and function except with respectto the additional retaining member features discussed below. As such,implant 460 is understood to include any or all of the features of theother implants described herein to the extent consistent with theadditional features of implant 460 described herein (e.g., retentionpins, dovetail projections and ramped surfaces, alignment features,control member access port(s), etc.).

According to an exemplary embodiment, implant 460 includes a first, orfront portion 462, a second, or rear portion 464, and a third,intermediate, or control member or portion 466, which collectively forma body or control assembly that extends along a longitudinal axis ofimplant 460. A first, or upper support 468 (e.g., an upper plate orsupport member, etc.) and a second, lower support 470 (e.g., a lowerplate or support member), are coupled to the body or control assemblyand may extend generally between front and rear portions 462, 464.According to an exemplary embodiment, first and second supports 468, 470define a height of implant 460 extending between the outer or topsurface of first support 468 and the outer or lower surface of secondsupport 470. In some embodiments, top and bottom supports 468, 470 mayinclude tapered corner sections 490, 492 to facilitate insertion/removalof implant 460, etc.

In one embodiment, top and bottom supports 468, 470 are retained byupper and lower pins 494, 496. In one embodiment, upper pins 494 extendthrough opposite sides of one end of top support 468, and lower pins 496extend through opposite sides of an opposite end of bottom support 470.Pins 494, 496 act to limit expansion of implant 460 and prevent removalof top and bottom supports 468, 470 from front and rear portions 462,464. As shown in FIG. 70, in one embodiment, two retaining pins extendinto each side of implant 460. In other embodiments, other numbers ofretaining pins may be used, as shown for example in various otherembodiments herein.

Referring further to FIG. 70, in some embodiments, implant 460 includesone or more retaining members to retain control member 466 in a desiredlongitudinal position. For example, as shown in FIG. 70, in oneembodiment, implant 460 includes retaining members 472 received in topand bottom apertures 474 on opposing top and bottom sides of rearsupport 464. Control member 466 includes a head portion 480, a groove482, and a threaded portion 484. Control member 466 further includes atool recess 486 in fluid communication with access ports 488. Retainingmembers 472 are configured to extend through rear support 464 and bereceived within groove 482 of control member 466, such that controlmember 466 is longitudinally fixed relative to rear support 464, butalso rotatable relative to rear support 464. FIG. 70 illustratesretaining members 472 extending into rear support 464 from opposing topand bottom sides. In various alternative embodiments, retaining membersmay be used that extend through other portions, such as opposing lateralsides. (e.g., as discussed with respect to implant 410)

Referring now to FIGS. 71-75, an implant 510 is shown according to anexemplary embodiment. Implant 510 is usable, for example, between and/orwithin vertebral bodies of the spine, and may share many of the featuresof the other inter/intra-body implants discussed elsewhere herein. Itshould be understood that implant 510 may in some embodiments be usablein other portions of the body in addition to the spine, and all suchapplications are to be understood to be within the scope of the presentdisclosure. Implant 510 is generally similar to the other implantsdiscussed herein in structure and function except with respect to thetwo-piece top and bottom support member features discussed below. Assuch, implant 510 is understood to include any or all of the features ofthe other implants described herein to the extent consistent with theadditional features of implant 510 described herein.

According to an exemplary embodiment, implant 510 includes a first, orfront portion 512, a second, or rear portion 514, and a third,intermediate, or control member or portion 516, which collectively forma body or control assembly that extends along a longitudinal axis ofimplant 510. A first, or upper support assembly 518 (e.g., an upperplate or support member, etc.) and a second, lower support assembly 520(e.g., a lower plate or support member), are coupled to the controlassembly and may extend generally between front and rear portions 512,514. According to an exemplary embodiment, first and second supportassemblies 518, 520 define a height of implant 520 extending between theouter or top surface of first support assembly 518 and the outer orlower surface of second support assembly 520.

Front portion 512 includes ramped surfaces 562 and a threaded bore 564.Rear portion 514 includes dovetailed projections 566 and recess oraperture 568. Ramped surfaces 562 and dovetailed projections 566facilitate controlled expansion and contraction of top support assembly518 and bottom support assembly 520 relative to one another.

In one embodiment, top support assembly 518 includes a first portion 522and a second portion 524 pivotally coupled to first portion 522 by wayof a top pivot pin 530. First portion 522 defines an extension portion532 that at least partially extends into a recess 534 in second portion524. Top guide pins 526 extend through second portion 524 and into upperslots 528 in first portion 522 to limit the range of pivotal motion offirst portion 522 relative to second portion 524 about top pivot pin530. First portion 522 includes a ramped surface 536, and second portion524 includes a dovetailed recess 538. Ramped surface 536 slidinglyinterfaces with a corresponding ramped surface 562 on front portion 512,and dovetailed recess 538 slidingly interfaces with a dovetailedprojection 566 on rear portion 514.

In one embodiment, bottom support assembly 520 includes a first portion542 and a second portion 544 pivotally coupled to first portion 542 byway of a bottom pivot pin 550. First portion 542 defines an extensionportion 552 that at least partially extends into a recess 554 in secondportion 524. Bottom guide pins 546 extend through second portion 544 andinto bottom slots 548 in first portion 542 to limit the range of pivotalmotion of first portion 542 relative to second portion 544 about bottompivot pin 550. First portion 542 includes a ramped surface 556, andsecond portion 524 includes a dovetailed recess 558. Ramped surface 556slidingly interfaces with a corresponding ramped surface 562 on frontportion 512, and dovetailed recess 558 slidingly interfaces with adovetailed projection 566 on rear portion 514.

In one embodiment, implant 510 includes alignment features configured tomaintain proper alignment between at least a portion of top supportassembly 518 and at least a portion of bottom support assembly 520. Forexample, an upper alignment guide 540 on second portion 524 of topsupport assembly 518 slidingly engages a correspondingly shaped loweralignment guide 560 on second portion 544 of bottom support assembly520. As such, as first portions 522 and 542 angulate away from eachother, second portions 524, 544 remain aligned (e.g., move in a linearfashion relative to one another.

In one embodiment, implant 510 is moveable from a first, fully collapsedand aligned position, as shown in FIG. 71, to a second, collapsed andangulated position, as shown in FIG. 72, to a third, expanded andangulated position, as shown in FIG. 73. Implant 510 may be positionedat any desired intermediate position between the first, second, andthird positions. In use, a first amount of rotation of control member516 causes angulation of first portions 522, 542 relative to secondportions 524, 544. As control member 516 is threaded into threaded bore564, first portion 522 rotates about top pivot pin 530 and first portion542 rotates about bottom pivot pin 550. First portions 522, 542 continueto angulate until top and bottom guide pins 526, 546 are retained byupper and lower slots 528, 548, which define the maximum amount ofangulation for first portions 522, 542.

Once maximum angulation is reached, further rotation of control member516 causes expansion of second members 524, 544 (and therefore alsofirst members 522, 542) relative to one another in a generally linearfashion (e.g., through the interaction of alignment guides 540, 560). Itshould be noted that to enable angulation of first portions 522, 542,front portion 512 and first portions 522, 542 have generally flat,correspondingly shaped ramped surfaces 562 (on front portion 512), 536(on first portion 522 of top support assembly 518), and 556 (on firstportion 542 of bottom support assembly 520). To facilitate linearmovement of second portions 524, 544, rear portion 514 includesdovetailed projections 566, which are received within dovetailedrecesses 438 (on second portion 524 of top support assembly 518) and 558(on second portion 544 of bottom support assembly 520).

The angulation and expansion features enable a user to initially installimplant 510 in a collapsed, aligned position, as shown in FIG. 71, whichmay facilitate initial insertion and adjustment of the device. Once inproper position, implant 510 may be moved to a desired angulated and/orexpanded configuration, as shown in FIGS. 72 and 73. In the fullyexpanded and angulated position, as shown in FIG. 73, the outer surfaces(e.g., top and bottom surfaces) of first portions 522, 542 are offset(e.g. angularly offset) from the outer surfaces of second portions 524,544, and angularly offset from the longitudinal axis of implant 510(e.g., an axis extending along control member 516). The amount ofangulation may be varied to suit a particular application (e.g., anamount of spinal curvature to be accommodated by the implant, etc.).

Referring now to FIGS. 76-83, an implant 610 is shown according to anexemplary embodiment. Implant 610 is usable, for example, between and/orwithin vertebral bodies of the spine, and may share many of the featuresof the other inter/intra-body implants discussed elsewhere herein. Itshould be understood that implant 610 may in some embodiments be usablein other portions of the body in addition to the spine, and all suchapplications are to be understood to be within the scope of the presentdisclosure. Implant 610 is generally similar to the other implantsdiscussed herein in structure and function except with respect to thetwo-piece top and bottom support member and specific control memberfeatures discussed below. As such, implant 610 is understood to includeany or all of the features of the other implants described herein to theextent consistent with the additional features of implant 610 describedherein.

According to an exemplary embodiment, implant 610 includes a first, orfront portion 612, a second, or rear portion 614, a first, or inner,control member 615, a second, or outer, control member 616, and areceiver member 617, which collectively form a body or control assemblythat extends along a longitudinal axis of implant 610. A first, or uppersupport assembly 618 (e.g., an upper plate or support member, etc.) anda second, lower support assembly 620 (e.g., a lower plate or supportmember), are coupled to the control assembly and may extend generallybetween front and rear portions 612, 614. According to an exemplaryembodiment, first and second support assemblies 618, 620 define a heightof implant 610 extending between the outer or top surface of firstsupport assembly 618 and the outer or lower surface of second supportassembly 620.

Front portion 612 includes ramped surfaces 654 and a receiver recess orbore 656. Rear portion 614 includes ramped surfaces 658 and controlrecess or bore 660. Ramped surfaces 654, 658 facilitate controlledexpansion and contraction of top support assembly 618 and bottom supportassembly 620 relative to one another.

In one embodiment, top support assembly 618 includes a first or innerportion 622 and a second or outer portion 624 pivotally coupled to firstportion 622 by way of a top pivot pin 626. First portion 622 at leastpartially extends into a recess 628 in second portion 624. First portion622 includes a ramped surface 630, and second portion 624 includes aramped surface 632. Ramped surface 630 slidingly interfaces with acorresponding ramped surface 654 on front portion 612, and rampedsurface 632 slidingly interfaces with a corresponding ramped surface 658on rear portion 614.

In one embodiment, bottom support assembly 620 includes a first or innerportion 638 and a second or outer portion 640 pivotally coupled to firstportion 638 by way of a bottom pivot pin 642. First portion 638 at leastpartially extends into a recess 644 in second portion 640. First portion638 includes a ramped surface 646, and second portion 640 includes aramped surface 648. Ramped surface 646 slidingly interfaces with acorresponding ramped surface 654 on front portion 612, and rampedsurface 648 slidingly interfaces with ramped surface 658 on rear portion614.

In one embodiment, implant 610 includes alignment features configured tolimit a degree of angulation of second portions 624, 640 relative tofirst portions 622, 638. For example, in some embodiments, first portion622 of top support assembly 618 includes a single alignment guide ormember 634 that is received between two alignment guides or members 650on first portion 638 of bottom support assembly 620. Alignment guides634, 650 are collectively received in a top alignment recess in secondportion 624 of top support assembly 618 and a bottom alignment recess644 in second portion 640 of bottom support assembly 620. The variousalignment components may be configured to enable a predetermined amountof angulation between first portions 622, 63 and second portions 624,640.

In one embodiment, implant 610 is moveable from a first, fully collapsedand aligned position, as shown in FIGS. 76 and 79, to a second, expandedand aligned position, as shown in FIGS. 77 and 80, to a third, expandedand angulated position, as shown in FIGS. 78 and 81. Implant 610 may bepositioned at any desired intermediate position between the first,second, and third positions. Furthermore, the order of expansion andangulation may be reversed, or alternated, during installation.

In use, threading of outer control member 616 into (or out of) receiver617 causes linear relative movement (e.g., expansion or contraction) oftop support assembly 618 and bottom support assembly 620. For example,FIGS. 77 and 80 show implant 610 with outer control member 616 havingbeen threaded into receiver 617 by way of threading engagement of theouter threads 668 of outer control member 616 and the inner threads 676of receiver 617. As front portion 612 and rear portion 614 movetoward/away from each other, top and bottom support assemblies 618, 620likewise move away from/toward each other.

Threading of inner control member 615 within outer control 616 membercauses second portions 624, 640 to angulate relative to first portions622, 638. For example, FIGS. 78 and 81 show implant 610 with innercontrol member 615 having been threaded into outer control member 616,causing second portions 624, 640 to rotate about top and bottom pivotpins 626, 642, causing second portions 624, 640 to become angularlyoffset relative to first portions 622, 638.

The angulation and expansion features enable a user to initially installimplant 610 in a collapsed, aligned position, as shown in FIGS. 76 and69, which may facilitate initial insertion and adjustment of the device.Once in proper position, implant 610 may be moved to a desired angulatedand/or expanded configuration, as shown in FIGS. 77-78 and 80-81. In thefully expanded and angulated position, as shown in FIGS. 78 and 81, theouter surfaces (e.g., top and bottom surfaces) of second portions 624,640 are offset (e.g. angularly offset) from the outer surfaces of firstportions 622, 638, and angularly offset from the longitudinal axis ofimplant 610 (e.g., an axis extending along outer control member 616).The amount of angulation may be varied to suit a particular application(e.g., an amount of spinal curvature to be accommodated by the implant,etc.).

Referring now to FIG. 84, a portion of an implant is shown according toan exemplary embodiment. In one embodiment, the portion includes amember 650, which may be similar to various components described withrespect to the various other embodiments disclosed herein. For example,member 650 may form part of a control assembly and act as a rear membersimilar to rear portions 14, 114, 214, etc. As shown in FIG. 84, accessto the interior of the various implants disclosed herein may be by wayof member 650. Member 650 includes a control member 652 and an accessaperture 654. Control member 652 acts to control expansion andcontraction of the implant, and aperture 654 enables access to theinterior of the implant. The access features of member 650 may beimplemented in any of the implant components described herein, includingthe various front and rear portions, top and bottom supports, etc. Allsuch combinations of features are to be understood to be within thescope of the present disclosure.

It is important to note that the construction and arrangement of theelements of the various implants and implant components as shown in theexemplary embodiments are illustrative only. Although a few embodimentshave been described in detail in this disclosure, those skilled in theart who review this disclosure will readily appreciate that manymodifications are possible (e.g., variations in sizes, dimensions,structures, shapes and proportions of the various elements, values ofparameters, mounting arrangements, materials, colors, orientations,etc.) without materially departing from the novel teachings andadvantages of the subject matter recited in the various embodiments.Accordingly, all such modifications are intended to be included withinthe scope of the present disclosure as defined in the appended claims.The order or sequence of any process or method steps may be varied orre-sequenced according to alternative embodiments. Other substitutions,modifications, changes, and/or omissions may be made in the design,operating conditions, and arrangement of the exemplary embodimentswithout departing from the spirit of the present disclosure.

What is claimed is:
 1. An expandable implant, comprising: an uppersupport comprising a top surface configured to engage a first portion ofbone; a lower support comprising a bottom surface configured to engage asecond portion of bone; a control assembly coupled to the upper supportand the lower support and configured to control relative movementbetween the upper support and the lower support, wherein the controlassembly comprises: a control shaft comprising a head; a front portionconfigured to translate along the control shaft and comprising a firstramped surface and a second ramped surface, the first ramped surfaceconfigured to slide relative to and provide a first force to the uppersupport, the second ramped surface configured to slide relative to andprovide a second force to the lower support; and a rear portionlongitudinally fixed relative to the control shaft and comprising athird ramped surface and a fourth ramped surface, the third rampedsurface configured to slide relative to and provide a third force to theupper support, the fourth ramped surface configured to slide relative toand provide a fourth force to the lower support; and first and secondretaining members extending through the rear portion and engaging acircumferential groove in the head of the control shaft; whereinrotation of the control shaft causes the front portion to translatealong the control shaft and causes the upper support to move relative tothe lower support.
 2. The implant of claim 1, wherein the head of thecontrol shaft comprises a recess in communication with an access portextending from a side of the control shaft to enable delivery of bonegrowth material via the recess and the access port to an interior of theimplant.
 3. The implant of claim 2, wherein the access port comprises apair of access ports provided on generally opposite sides of the controlshaft.
 4. The implant of claim 3, wherein the recess extends along alongitudinal axis defined by the control shaft, and wherein each accessport of the pair of access ports extends from the recess in anon-perpendicular fashion relative to the longitudinal axis.
 5. Theimplant of claim 2, wherein the control shaft comprises a threadedportion configured to threadingly engage the front portion, and whereinthe access port is provided between the head and the threaded portion.6. The implant of claim 1, wherein the first retaining member extendsthrough a first side of the rear portion and the second retaining memberextends through a second side of the rear portion opposite the firstside of the rear portion.
 7. The implant of claim 1, wherein the each ofthe first retaining member and the second retaining member comprises acurved surface configured to curve along the circumferential groove. 8.The implant of claim 1, wherein the implant is symmetric about a planeextending along the control assembly and perpendicular to the topsurface and the bottom surface.
 9. The implant of claim 1, wherein oneof the upper support and the lower support comprises an alignment guideconfigured to be received in a correspondingly-shaped alignment recesson the other of the upper support and the lower support.
 10. The implantof claim 9, wherein the alignment guide comprises first and secondalignment guides extending along opposite lateral sides of the uppersupport, and wherein the alignment recess comprises a first alignmentrecess provided on the lower support and configured to receive the firstalignment guide and the a second alignment recess provided on the lowersupport and configured to receive the second alignment guide.
 11. Anexpandable implant, comprising: an upper support comprising a topsurface configured to engage a first portion of bone; a lower supportcomprising a bottom surface configured to engage a second portion ofbone, wherein the top surface and the bottom surface taper towardbetween lateral sides of the implant; and a control assembly coupled tothe upper support and the lower support and configured to controlrelative movement between the upper support and the lower support,wherein the control assembly comprises: a control shaft; a front portionconfigured to translate along the control shaft and provide a firstforce to the upper support and provide a second force to the lowersupport; and a rear portion longitudinally fixed relative to the controlshaft and provide a third force to the upper support and provide afourth force to the lower support; wherein one of the upper support andthe lower support comprises an alignment guide, the alignment guidecomprising parallel side surfaces and being configured to be received ina correspondingly-shaped alignment recess on the other of the uppersupport and the lower support; wherein rotation of the control shaftcauses the front portion to translate along the control shaft and causesthe upper support to move relative to the lower support.
 12. The implantof claim 11, wherein the top surface and the bottom surface define ataper, wherein the taper remains constant during movement of the uppersupport relative to the lower support.
 13. The implant of claim 12,wherein the taper extends in a direction generally perpendicular to thecontrol shaft.
 14. The implant of claim 11, further comprising first andsecond retaining members extending through the rear portion and engaginga circumferential groove in a head of the control shaft.
 15. The implantof claim 11, wherein the first retaining member extends through a firstside of the rear portion and the second retaining member extends througha second side of the rear portion opposite the first side of the rearportion.
 16. The implant of claim 11, wherein the front portioncomprises a first ramp surface that provides the first force and asecond ramped surface that provides the second force, and wherein therear portion comprises a third ramped surface that provides the thirdforce and a fourth ramped surface that provides the fourth force.
 17. Animplant comprising, an upper support comprising a top surface configuredto engage a first portion of bone; a lower support comprising a bottomsurface configured to engage a second portion of bone; a controlassembly coupled to the upper support and the lower support andconfigured to control relative movement between the upper support andthe lower support, wherein the control assembly includes: a frontportion configured to engage and move relative to the upper and lowersupports; a rear portion configured to engage and move relative to theupper and lower supports; and a control member comprising a head andcoupled to the front portion and the rear portion such that rotation ofthe control member causes movement of the front portion relative to therear portion, wherein the rear portion is longitudinally fixed relativeto the control member; a first retaining member extending through afirst side of the rear portion and received in a circumferential groovein the head; and a second retaining member extending through a secondside of the rear portion opposite the first side and received in thecircumferential groove in the head.
 18. The implant of claim 17, whereinthe upper support comprises first and second alignment guides alongopposite lateral sides of the upper support, each of the first andsecond alignment guides comprising generally parallel sides; wherein thelower support comprises a first alignment recess provided on the lowersupport and configured to receive the first alignment guide and the asecond alignment recess provided on the lower support and configured toreceive the second alignment guide.
 19. The implant of claim 18, whereinthe control member further comprises a threaded portion, and an accessport provided between the head and the threaded portion, wherein theaccess port is in communication with a recess in the head to enabledelivery of bone growth material to an interior of the implant.
 20. Theimplant of claim 17, further comprising a first lateral side extendingbetween the top surface and the bottom surface and a second lateral sideopposite the first lateral side and extending between the top surfaceand the bottom surface; wherein the first lateral side has a greaterheight than the second lateral side when the implant is in a collapsedposition.